HomeMy WebLinkAboutMEADOW BROOK BLK 1 LT 2Meadow Brook Lot 2 Block 1 #050-191-38 Municipality of Anchorage - WA 31 2013 Community Development Department Page 1 of 3 On -Site Water & Wastewater Program 4700 Elmore St. • P.O. Box 196650 Anchorage, AK 99519-6650 • httpY/www.muni.org/onsite • (907)343-7904 ON-SITE WASTEWATER INSPECTION REPORT Permit Number: OSP131104 PID Number: 050-191-38 ❑ New ®Upgrade Name: SCOTT MCKINNIS ABSORPTION FIELD Address: —El Deep Trench ❑ Shallow Trench ElBed ElMound 18322 KANTISHNA DR. *EAGLE RIVER, AK 99577 n nthAr N/A Depth from LEGAL DESCRIPTION GPD/Sq. Ft. Depth to pipe invert from original grade: FG Ft. Grovel depth beneath e: Ft. Subdivision: MEADOW BROOK Black: Lot: 1 2 RII added above original grade: Grov ngth: owns Ip: ange: ec on: —— — Gravel width: ` Ft. eds Number of lines: Distance between lines: J\S�\,�` E R. R. SEPARATION TO DISTANCES eptic AbsorptionF'tfiton ank Field Pr4vate Station TankLines Total ab.0" area: 54. Ft. umber of trenches: Dist between trench.®: Ft 00'+ EXISTING'+ TANK ® Se tic ❑ S.T.E.P. ❑Holdin ❑Other 00'+ EXISTINGANCHORAGE Manufacturer:Capacity: TANK 10005'+ EXISTINGA Material: Number of compartments:STEEL 2 5'+ EXISTING LIFT STATION NONE KNOWN Manufacturer, Capacity: Gal. Remarks: OLD TANK WAS DECOMMISSIONED PER UPC *Pump on" level at: •Pomp on level at NI a alarm at; Pump Make & Mode- trical Inspections performed by: PIPE MATERIAL House to tank D3034 Tank to D3034 drainfield Installer JR'S PUMPING Drainfield EXISTING CO/MT EXISTING Inspector GEG, Ltd. BENCH MARK (Assumed elevation) - 100.00 Ft Inspection Dates: 1st 5/24/ 13 2nd – Location and Description: 3rd – 4th – DOOR OF THRESHOLD Community Development ENO MEERB Department Approval Conditional approval: Date: oo�oo v qS�O TH yp Qo �....:........ . ........... . - 0...J .f. .. Gar ss.: OQ� Approved, PP Ddte: QO sf ^ E7793 0 •,�0� 4� a ;/3o Ib ao 4��a °rofesslop°oma 0400000 PERMIT NUMBER: OSP131104 AS -BUILT DRAWING PARCEL ID NUMBER: 050-191-38 / / MEADOW BROOK; BLOCK 2, LOT 4 / / / '.ASN ., • : . so / \ \ NEW 1000 - \ �� \ GALLON SEPTIC TANK \o \ 4 EXISTING 3 BEDROOM HOUSE B DBL1 EXISTING - \ GRAINFIELD l A B / STI 17.63 48.43 ST2 / / 49.44 / MEADOW BROOK; BLOCK 1, LOT 3 PUBLIC WATER \ \ NEW 1000 - \ �� \ GALLON SEPTIC TANK \o \ 4 EXISTING 3 BEDROOM HOUSE B DBL1 EXISTING - \ GRAINFIELD l A B / STI 17.63 48.43 ST2 23.12 49.44 DBL1 29.15 48.72 DSL2 30.97 47.62 CRIB 40.96 43.68 FCO 10.15 44.82 MEADOW BROOK; BLOCK 1, LOT 1 UPUBLIC WATER I MEADOW BROOK; BLOCK 1, LOT 4 PUBLIC WATER / / / / Q / 1 / / GARNESS ENGINEERING GROUP, Ltd. CONSULTANTS & GE14FRAL CONTRACTORS 3701 E 111008 ROM, SUITE 101 • INCHOfULE, M 9990) • PWW (907)W7-8179 • FM (907)338-3218 • NE080£ w wr o nuen91n11Rn9=m PREPARED FOR: PHONE NUMBER: PAGE NUMBER: SCOTT MCKINNIS N/A 2 OF 3 LEGAL DESCRIPTION: DRAWN BY: MEADOW BROOK; BLOCK 1, LOT 2 PNB TYPE OF WORK: DATE: AS -BUILT DRAWING 5/30/13 I I I I IPERMIT NUMBER: AS—BUILT DRAWING PARCEL ID N OSP131104 050-191-38UMBER: TOP OF TANK AT INLET = 93.55 INVERT OF BUNG AT INLET = 92.92 ST1 GRADE = 97.64-97.77 ST2 NEW 1000 GALLON SEPTIC TANK GARNESS ENGINEERING GROUP, Ltd - CONSULTANTS & GENERAL CONTRACTORS 3701 E MMR 80.00, 51111E 101 • MCX WE. M 99W7 • NME (907)33)-8179 • FM (907)339-320 M n..: wwy,9amerngimer(n9.cem PREPARED FOR: PHONE NUMBER: PAGE NUMBER: SCOTT MCKINNIS N/A 3 OF 3 LEGAL DESCRIPTION: DRAWN BY: MEADOW BROOK; BLOCK 1, LOT 2 PNB TYPE OF WORK: DATE: PROFILE AS—BUILT DRAWING 5/30/13 (Rev. 01/ ) — TOP OF TANK AT OUTLET = 93.55 INVERT OF BUNG AT OUTLET = 92.75 Permit Number: Tax Code Number: On -Site Wastewater Disposal System Permit OSP131104 05019138000 Work Type: Septic Permit Effective Dates: May 24, 2013 Design Engineer: GARNESS ENGIN Subdivision: MEADOW BROOK MUNICIPALITY OF ANCHORAGE Development Services Department On -Site Water & Wastewater Program 4700 Elmore Road, PO Box 196650 Anchorage, AK 99519-6650 Telephone: (907) 343-7904 to May 24, 2014 GROUP LTD Site Legal Address: MEADOW BROOK BILK 1 LT 2 G:0153 Owner/Address: MCKINNIS SCOTT H & MCKINNIS SANDRA K 18322 KANTISHNA DR EAGLE RIVER AK 995770000 Site Mailing Address: 18322 KANTISHNA DR, Eagle River This permit is for the construction of: N Disposal Field Y Septic Tank N Holding Tank N Privy S"'g4hr ' -I!" Lot Size in Sq Ft: 10559 Total Bedrooms: 3 N Private Well N Water Storage All construction must be in accordance with: 1. The attached approved design. 2. All requirements specified in Anchorage Municipal code Chapters 15.55 and 15.65 and the State of Alaska Wastewater Disposal Regulations (18AAC72) and Drinking Water Regulations (18AAC80). 3. The wastewater code requires inspections during the installation. The engineer must notify the Development Services Department at least 2 hours prior to each inspection. Provide notification by calling (907) 343-7904 (24 hours). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must either: A. Open and Close on the same day. B. Covered, sealed, and heated to prevent freezing. Received B� Issued By: e me"Vt (3'�L %-it, MUNICIPALITY OF ANCHORAGE Community Development Department Development Services On -Site Water & Wastewater Program Mayor Dan Sullivan Phone: 907-343-7904 Fax: 907- 343-7997 On -Site Sewer/Well Permit Application /` ,,,-For A Single Family Dwelling Parcel I.D. V �J d - 1 %',,6 Property owner(s) SCOTT & SANDRA MCKINNIS Day phone Mailing address 18322 KANTISHNA DRIVE *EAGLE RIVER. AK 99577 Site address 18322 KANTISHNA DRIVE *EAGLE RIVER, AK 99577 Legal description (Sub'd, Block & Lot) MEADOW BROOK; BLOCK 1, LOT 2 Legal description (Township, Section & Range) Lot Size Sq.Ft. Number of Bedrooms 3 APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DEWELLING: (Pall that apply) Initial ❑ Single Family (SF) Absorption Field ❑ Upgrade ® (w/wo ADU) Septic Tank ® Duplex (D) ❑ Renewal ❑ Holding Tank ❑ Multiple Dwellings ❑ Privy ❑ (SF and/or D) Private Well ❑ Water Storage ❑ THIS APPLICATION INCLUDES A VARIANCE/ WAIVER REQUEST FOR: Distance: I certify that the above information is correct. I further certify that this is in accordance with applicable Municipal codes. GARNESS ENGINEERING GROUP, Ltd. (Signature of property owner or authorized agent) Permit/Rush Fees: (�C� 66 Waiver Fees: Date of Payment: 6L9 Ll L3 Date of Payment: Receipt Number: X635-(4�g Receipt Number: Permit No. aSP/2//ail Waiver No. (Rev. 01/11) ♦ ►. ►► i i % Inr. ♦ - ! May 24, 2013 Municipality of Anchorage Development Service Department On -Site Water & Wastewater Program 4700 Elmore Rd. P.O. Box 196650, Anchorage, Ak 99519-6650 (907)343-7904 Ref: Proposed Septic Tank Upgrade for Meadow Brook; Block 1, Lot 2; (Immediate Replacement) To whom it may concern: The existing 3 bedroom house is served by a private septic system and public water. The existing septic tank was inspected by the property owner and found to be collapsing. We are proposing to remove the existing tank and replace it with a new 1000 gallon septic tank. We are unaware of any adverse impacts this installation would have on adjacent wells or septic systems. contact us at 337-6179. Thank you for your assistance. 3701 E. Tudor Road, Suits 101 *Anchorage, AK 99507-1259 Ph: (907) 337-6179 * Fax: (907) 338-3246 * Website: www.gamessengineering.com \ MEADOW BROOK; BLOCK 2, LOT 4 MEADOW BROOK;. BLOCK 2, LOT 3 MEADOW BROOK; BLOCK 1, LOT 2 \ MEADOW BROOK; \ BLOCK 1, LOT 3 PUBLIC WATER INSTALL FCO - PROPOSED 1000 GALLON SEPTIC \ �i�v \ \ TANK / INSTALL DBL- \ C/0 S NOTE: THE CONTRACTOR SHALL HAVE THE WEST PROPERTY LINE FLAGGED BY \ A REGISTERED LAND SURVEYOR PRIOR TO CONSTRUCTION. LETTER THAT PERTAINS TO THIS DESIGN. TO OBTAIN A COPY OF THE LE17ER CONTACT GEG. BY PROCEEDING FORWARD WITH THIS INSTALLATION, THE ENGINEER, WELL DRILLER, CONTRACTOR AND PROPERTY OWNER AGREE THAT THEY HAVE READ THESE SPECIFICATIONS AND AGREE TO ACCEPT THE TERMS AND EXISTING 3 BEDROOM HOUSE EXISTING - DRAINFIELD -EXISTING 1000 GALLON SEPTIC -� TANK TO BE MEADOW BROOK; BLOCK 1, LOT 1 PUBLIC WATER MEADOW BROOK; BLOCK 1, LOT 4 PUBLIC WATER / GARNESS EINEERING GROUP, Ltd. CONSULTANTS & GENERAL CONTRACTORS 3'!01 L 10009 ROM, SURE 101 • I HPIAE, M 9850') • PHONE (90))33)-8118 • FV( (207)338-3M • WE n. wxwAcrmuen4�wenn9.com PREPARED FOR: PHONE NUMBER: PAGE NUMBER: SCOTT & SANDRA MCKINNIS N/A 1 OF 1 LEGAL DESCRIPTION: DRAWN BY.- MEADOW Y:MEADOW BROOK; BLOCK 1, LOT 2 PNB TYPE OF WORK: DATE: UPGRADE 3 MUNICIPALITY OF ANCHORAGE DE ITMENT OF HEALTH AND HUMAN SER cS Environmental Health Division 825 "L" Street, Anchorage, Alaska 99502, Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT Name \ I DISTANCES --rte SEPTIC ABSORPTION Address FAOM TANK FIELD WELL a _L0 ���(z �� �7. WELL Phonea) Permit No. No of Bedrooms 2�D) to -SSoo IP _�. LEGAL DESCRIPTION LOT LOT LINE Lot Block S bd vision i �® -� �_ FOUNDATION Ik Township. Range, Section _ AS -BUILT DIAGRAM (Show, location of well. septic system. property lines, foundation, _I � �!i• driveway. water bodies, etc.) TANKS l l _ w TT- SEPTIC (] HOLDING Manu;acw;cr � Capacity in gallons Material) No. of Compartments TYPE Or SYSTEM Cl TRENCH ❑ BED ;9--W. DRAIN ❑ OTHER Depth to pipe bottom from I f Total deplh from original grade original grade S- C FT _ I FT Fill added above original grade Gravel depth beneath pipe FT �7,`� FT Gravel length Gra+el witlih �7Z FT FT Total absorption area i Distance between lines 12 %6SO FT 17�_T Number of lines Sod rating Pipe matenal 1i SQ FT ,tea Installer Dale Ins1�Cd WELLS ❑ PRIVATE �`C)THER (Identifv) 91111 classification (A, B.C) Total Depth Cased to � 2 FT Cased FT ' --- Installer Dale Ix In/nstalletl. REMARKS: 'fL&L_E !mac (JJ v F THE C c, 815E I LZ03A-Eaule 121.ver Ldop Road No. 204 aple Fiver, Alaska 99577 r Municipal and to gut elines In effect on This dg I Health Department Approval: 72--0013 (3/85) Date: 2 l' U o"F'1y� 3 V 11 FEN1,r MUN / -t-t 11 -1p., scale: 0 .1-1 17 • Inspections Perior�fned by. C ~C- Date. 1 if1 .2 _<� that [hiss speclion was performed according to all , ; 7 Date: 2 l' U o"F'1y� 3 V 11 FEN1,r MUN r �•' J;rtt�`.1�t'r r�. / �' S��i• I:01 A JET � .,•_,-; ,a; l I S CvCs• bAlOwn TV! � & S �N6lN��RlNG 1/OJ4 E. R. LOOP #�04 E86L� klV|�R, AK 99677 PHUN� #694-2�79 PERMlT .1. IJ API ANl: �UNN1� �AlES HD0RESS: P.U. 8UX //l699 �H6Li I VEH (III.. CONTAC[ PHUN!: b94�5500 SPEC1AL CONU[|IU�S UR INS[RUC[1dNS: �Hl� /S AN UP�HADE FRUM | 1 [U FOUR Bi:U|eUUMS. FlELG PASS�6 AN ADEQUACY {ES| FOR TWO BEDHOOMS. 1-�- Fjy/s7//^,- A /7c — A/ k-, [H� EXISllN6 HUSUKHluN �I /V0 /^��7-�I Z-/ 4 /2 5D 6-`,A/ �^�� J Tj cp � � T 7_ El: N e4 6 Qw Q 4K �P 3lVJS u Municipality of Anchorage K DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG ® PERCOLATION TEST V- u (`` 0 At (E$�a VEER'S SEAL) '44x� {�1 V / �, PERFORMED FOR: I1rl �(,��'/YN, �.+'�xL DATE PI�`.f� LEGAL DESCRIPTION:I-'";- FJ 1 � Hca �V Township, Range, Section: , r T,M, © � SLOPE SITE 2 3- 4- Jr� 5 0 'a 6 7 o - 8_ J 9 10 12 - p; 0 Y 13 14 15 16 17- 18 19 20 COMMENTS cjr - WAS GROUND WATER ENCOUNTERED? S IF YES, AT WHAT L 0 DEPTH? P E Depth to Water AIIA Moniloring? LA�Date: 5 r�61 PERCOLATION RATE ka- 1 (minutes/inch) PERC HOLE DIAMETER TEST RUN BETWEEN 10 FT AND —I-- FT PERFORMED BY: I CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE. 72-008 (Rev. 4/85) �m PERCOLATION RATE ka- 1 (minutes/inch) PERC HOLE DIAMETER TEST RUN BETWEEN 10 FT AND —I-- FT PERFORMED BY: I CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE. 72-008 (Rev. 4/85) Municipality of Anchorage �p • Development Services Department Building Safety Division S n E r ,. On -Site Water & Wastewater Program 4700 Elmore Road P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.org/onsite � (907) 343-7904 )RTIFICATE OF ON-SITE SYSTEMS APPROVAL FOR A SINGLE FAMILY DWELLING F cOSA# 05C l 1 >5`( Parcel LID. 050-191-38 � Q 1. GENERAL. INFORMATION Expiration Date. O �� Complete legal description Location (site address) Current Property owner(s) Mailing address Lending agency Mailing -address Real Estate Agent Mailing address MEADOW BROOK; BLOCK 1, LOT 2 18322 KANTISHNA DRIVE *EAGLE RIVER, AK 99577 PATRICIA KIGHT Day phone C/O AGENT 18322 KANTISHNA DRIVE *EAGLE RIVER AK 99577 Day phone PARTNERS REAL ESTATE Day phone 694-9588 11940 BUSINESS BLVD #202 *EAGLE RIVER AK 99577 Unless otherwise requested, COSA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: 3 3. TYPE OF WATER SUPPLY: TYPE OF WASTEWATER DISPOSAL: Individual Well ❑ Individual On-site 0 Individual Water Storage ❑ Individual Holding tank ❑ Community Class Well ❑ Community On-site ❑ Public Water System 0 Public Sewer ❑ The Municipality of Anchorage Development Services Department (DSD) Issues Certificates of On -Site Systems Approval (COSA) based only upon the representations given in paragraph 4 by an independent professional civil engineer registered in the State of Alaska. Certificates of On -Site Systems Approval are required for the transfer of title (except between spouses) for properties served by a single-family on-site wastewater disposal and/or water supply system. DSD also issues COSAs upon request to homeowners. Certificates of On -Site Systems Approval are valid for 90 days from the date of issue for properties served by a private or Class C well and may be reissued with new water samples. (Certificates may be reissued for a period of up to one year with valid water samples.) Certificates are valid for one year for properties served by Class A or B wells or a public water system. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 4. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation, based on procedures outlined in the Certificate of On -Site Systems Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system is (are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. 1 further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is(are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. Name of Firm GARNESS ENGINEERING GROUP, Ltd. Address 3701 E. TUDOR ROAD, SUITE 101 * ANCHORAGE, AK 99507 Engineer's Printed Name JEFFREY A. GARNESS, P.E. Engineer's Comments: In conducting this evaluation, GEG, LtD. attempted to provide a thorough, conscientious engineering analysis of the system in accordance with ADEC and MOA DSD Guidelines & Regulations. The reported results described the performance of the system under the conditions encountered at the time of the test, and separation distances measured to readily identifiable features. The operational life of all wells and septic systems depend on the local soils condition, groundwater levels that may fluctuate during the year, and the water usage of the family being served by the system. These conditions are outside the control of the evaluator of the system. Satisfactory test results do not guarantee future performance of the system, nor do they guarantee that there are no hidden defects or encroachments. GEG, LTD. can therefore not provide any warranty or future estimate of how long the system will continue to meet the operational requirements of the ADEC or MOA DSD. The content of this report is for the sole benefit of the owner listed above. Any reliance upon or use of this report by any other person or party is not authorized, nor will it confer any legal right whatsoever. 5. DSD SIGNATURE ! Approved for bedrooms. Disapproved. Phone 337-6179 Date Z 11 Conditional approval for bedrooms, with the following stipulations: Attachments: COSA Checklist Septic System Advisory Well Flow Advisory L -1 - Arsenic Advisory Maintenance Agreements Supplemental Engineer's Report �1iVIt113!tlir ��y of ONSITE ••�G► 1 ATER AND '. v ; WASTEWATER PROGRAM '11,7, ftT SEN" Nitrate Advisory Other By: C��� J Original Certificate Date: 9 , (Rev. 11105) Municipality of Anchorage Development Services Department Building Safety Division ; A ; r'T';.' On -Site Water & Wastewater Program 4700 Elmore Road P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.org/onsite (907) 343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL CHECKLIST Legal Description: MEADOW BROOK; BLOCK 1, LOT 2 Parcel ID: 050-191-38 A. WELL DATA PUBLIC WATER Well type If A, B, or C provide PWSID# Well Log (Y/N) Date completed Sanitary seal (Y/N) Wires properly protected (Y/N) Total depth ft. Cased to ft. Casing height (abo round) T11 FROM WELL LOG AT IN CTION Date of test Static water level ft. ft. Well production g.p.m. g.p.m. WATER SAMPLE RESU Coliform colonies/100 ml. Nitrate mg./L. Collected by: A ic: —ug./L. Date of sample: B. SEPTIC/HOLDING TANK DATA *INSIDE CRAWLSPACE Tank Type/Material SEPTIC/STEEL Date installed 1972 Tank size 1000 gal. Number of Compartments **1 Cleanouts (Y/N) YES Foundation cleanout (Y/N) *YES Depression over tank (Y/N) NO High water alarm (Y/N) N/A Date of pumping I Pumper 0 he, e- �62 Se /v j C e .S C. ABSORPTION FIELD DATA *BELOW ExiSTI cRAOE Date installed 1972 Soil rating (g.p.d./ft2or Z/bdrm UNK System type **SEEPAGE PIT Length 17 ft. Width 17 ft. Gravel below pipe **6 ft. Total depth *12.16 ft. Eff. absorption area 406 ft2 Monitoring tube YES Depression over field NO Date of adequacy test 9/22/11 Results (Pass/Fail) PASS For 3 bedrooms Fluid depth in absorption field before test 31 in. Water added 750 gal. New depth 53 in. Elapsed Time: 1042 min. Final fluid depth 37 in. Absorption rate >= 450+ g.p.d. Any rejuvenation treatment (past 12 mo.) (Y/N & type) NONE KNOWN If yes, give date — **BASED UPON PREVIOUS COSA'S D. LIFT STATION Date installed Size in gallons Manhole/Access (Y/N "Pump on" level at in. "Pump ofr level High water alarm level at in. Cycles tested Meets alarm $ circuit requirements? E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tank/lift station on lot Absorption field on Public sewer main Sewer /septic service line Animal On adjacent lots On adjacent lots manhole/cleanout Holding tank Manure/animal excrete storage areas SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation Water main 5'+ 10'+ Wells on adjacent lots 100'+ Property line 5'+ Absorption field 5'+ Water service line 10'+ Surface water 100'+ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line *10'+ Building foundation 10'+ Water main 10'+ Water service line 10'+ Surface water 100'+ Driveway, parking/vehide storage 10'+ Curtain drain NONE KNOWN Wells on adjacent lots 100'+ F. COMMENTS *ASSUMED SEEPAGE PIT C/O IS APPROX. 15' FROM LOT LINE. POST TANK C/O COULD NOT BE FOUND. MOA'S JEFF POET SAID IT WAS NOT A CONCERN���_ G. ENGINEER'S CERTIFICATION o -"OF A i certify that I have determined through field inspections and * : 4VT7H review of Municipal records that the above systems are in conformance with MOA COSA guidelines in effect on this date• e f y Go ness: Engineer's Printed Name JEFFREY A. GARNESS �Q CE -7 e, s •cG Date °!/�� //l 0fessio COSA Fee 0 ( `Y kIAM Waiver Fee $ Date of Payment/'g-// % Date of Payment Receipt Number Q �'� Receipt Number (Rev. 11/05) ASBUILT SUTARD & ASSOCIATES LAND SURVEYING 694-0829 I HEREBY CERTIFY THAT I HAVE SURVEYED THE SCALE: �� d4�o��sa FOLLOWING DESCRIBED PROPEf?TY: Of A` EXIST ANTNO E.NC.ROACHM&T XCEPT A5 dATE:THAT y ��•' ••' �r �, •. INDICATED. IT IS THE RESPONSISI LI TY OF THE 9�7�os i : T H� _ OWNER TO DETERMINE THE EXISTENCE OF ANY GRID: OF •: •••• ••••�••• EASEMENTS, COVENANTS, OR RESTRICTIONS -114, ism f, h. r WHICH DO NOT APPEAR ON THE RECORDED SUBDI-„ •., o.,.�, M,�. a ;• r VISION PLAT. UNDER NO CIRCUMSTANCES SHOULD FB` f ••. is A9 > ANY DATA HEREON BE USED FOR CONSTRUCTION /�B �z tt `•'t�,'��f • .•��J��� OF FENCE LINES, OR FOR ESTABLISHING BOUND-;�Nr-si<.ca'�-�•r ARY LINES. DRAWN. * n �� �.• lYq<i�. Municipality of Alorage ,• -� Development Services Department .< i Building Safety Division On -Site Water and Wastewater Program , • I r , 4700 Bragaw�Street P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.org/onsfte (907) 343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. oro-agi-38 COSA # Q 1 G :2 7 Expiration Date: 2 �^ 1. GENERAL INFORMATION Complete legal description Meadow Brook Blk 2 Lt;t Location (site address) 28322 Knantishna Dr Eagle River AK 99sn Current Property owner(s) Brian & Kristi Kirk Day phone 230-4929 Mailing address 28322 Knantishna Dr Eagle River AK egtn Lending agency Day phone Mailing address Real Estate Agent Day phone Mailing Address Unless otherwise requested, COSA will be held by DSD for pickup. 2. NUMBER OF BEDROOMS: 3 3. TYPE OF WATER SUPPLY: Individual Well ❑ Individual Water Storage ❑ Community Class Well ❑ Public Water System TYPE OF WASTEWATER DISPOSAL: Individual On-site ED Individual Holding Tank ❑ Community On-site ❑ Public Sewer ❑ The Municipality of Anchorage Development Services Department (DSD) Issues Certificates of On -Site Systems Approval (COSA) based only upon the representations given in paragraph 4 by an Independent professional civil engineer registered in the State of Alaska. Certificates of On -Site Systems Approval are required for the transfer of title (except between spouses) for properties served by a single-family on-site wastewater disposal and/or water supply system. DSD also issues COSAs upon request to homeowners. Certificates of On -Site Systems Approval are valid for 90 days from the date of Issue for properties served by a private or Class C well and may be reissued with new water sample results. (Certificates may be reissued for a period of up to one year with valid water samples.) Certificates are valid for one year for properties served by Class A or B wells or a public water system. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 4. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, 1 verify that my investigation, based on procedures outlined in the Certificate of On -Site Systems Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system is (are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my Investigation and inspection, the on-site water supply and/or wastewater disposal system is(are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. Name of Firm Pannone Engineering Services, LLC Phone _272-8228 Address P.O. Box 202954 Anchorage, AK ga52o Engineer's Printed Name Steven R. Pannone. P.E. Date 0Q625Ge) Engineers Comments: In conducting an adequacy test, I attempt to provide a thorough, conscientious engineering analysis of the system in accordance with MOA DSD Guidelines & Regulations. The reported results describe the performance of the system under the conditions encountered at the time of the test, and separation distances measured to readily identifiable features. .a The operational life of all wells and septic systems depend on the local soil condition, ground water •O� (� 4a a�� levels that may fluctuate during the year, and the water usage of the family being served by the system. These .•�p� LJ conditions are outside the control of the evaluator of this system. All systems eventually fail and satisfactory test results do not future do guarantee performance of the system, nor they guarantee that ggrH there are no hidden defects or encroachments. PES can therefore not provide any warranty for future 0-"' performance nor give any estimate of how long the system will continue to meet the operational i requirements of the MOA DSD. The content of this report is for the sole benefit of the owner listedSteve R. onnone [+� above. Any reliance upon or use of this report by any other person or party is not authorized nor will it confer any legal right whatsoever. �ic%o. CE 8149 �##i2s. 5. DSD SIGNATURE �a�`a0aa55;'6 ••• _—Z Approved for _. bedrooms. Disapproved. Conditional approval for bedrooms, with the following stipulations: Attachments: COSA Checklist Septic System Advisory Well Flow Advisory Nitrate Advisory X Arsenic Advisory Maintenance Agreements Supplemental Engineer's Report Other By: Original Certificate Date:.J CD Municipality of Anchorage i rr Development Services Department Building Safety Division On -Site Water & Wastewater Program ' 4700 Bragaw Street P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.org/onsite (907) 343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL CHECKLIST Legal Description: _Meadow Brook Bik i Lt 2 Parcel I0: o50 -29i-38 A- WELL DATA Well type public watersystgrnIf A, B, or C provide PWSID # _ Well Log (Y/N) Date completed _ Sanitary seal (Y/N) _ Wires property protect' ) Total depth ft\ Cased to ft. Casing hejqbf ( ove ground) in. Date of test Static water level Iti Well production g.p.m. \ g.p.m. WATER SAMPLE RE S: Coliform colonies/100 mL Nitrate mg/L . Other bac�'_colonles/1100ml_A enicug/I Date of sample: Collected B. SEPTIC/HOLDING TANK DATA Tank Type/Material stack Steel Date Installed s972 Tank size 2coo gal. Number of Compartments z assumed Cleanouts (Y/N) Y Foundation cleanout (Y/N) Y* Depression over tank (Y/N) JkO High water alarm (Y/N) N/A Date of pumping Oft-41Pumper One Stop Services C. ABSORPTION FIELD DATA Date installed ao72 Soil rating (g.p.d./ftz or fe/bdrm) UKNOWN System type _SEEPAGE PIT Length %7 ft. Width 27 ft. Gravel below pipe 6 assumed ft. Total depth j2 ft. Eff. absorption area o6.. ft2 Monitoring tube y Depression over field N Date of adequacy test 812 2000 Results (Pass/Fail) Pass For 3 bedrooms Fluid depth in absorption field before test 2 in. Water added4So gal. New depth2 in. Elapsed Time: Io min. Final fluid depth i in. Absorption rate >= a5o+ g.p.d. Any rejuvenation treatment (past 12 me.) (YM & type) NONE KNOWN If yes, give date D. LIFT STATION Date installed "Pump on" level at _ In. Datum E. SEPARATION DISTANCES Size "Pu p oft" evel in. Cycles tested SEPARATION DISTANCES FROM WELL ON LOT TO: Septic tankpift station on lot Absorption field on lot Public sewer main Sewer /septic service line Animal containment areas Manhole/Access (Y/N) High water alarm level at Meets alarm & circuit requirements? On adjacent lots On adjacent lots Public sewer manhole/cleanout Holding tank Manure/animal excrete storage areas SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOT TO: Building foundation 68 Property line sg, Absorption field 3o' Water main so+ Water service line _ ao+ Surface water _ zoo+ Wells on adjacent lots foo+ SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: Property line ii., Building foundation fix, Water main 3o+ Water Service line so+ Surface water _ioo+ Driveway, parking/Vehicle storage So+ Curtain drain _NONE KNOWN Wells on adjacent lots _soo+ F. COMMENTS G. ENGINEER'S CERTIFICATION I certify that I have determined through field Inspections and review of Municipal records that the above systems are in conformance with MOA COSA guidelines in effect on this date. Engineer's Printed Name Steven R. Pannone P.E. COSA Fee $ 7 q 0 Date of Payment 75 ' I V - l' !a Receipt Number 0 Ll U q, 0 9 (Rev. 11/05) Waiver Fee $ Date of Payment Receipt Number No. CE 8149 In. 11A�r"SNA N iPflE.�ii.�i�ria✓ s/�/y % Quul". JCWfU(U h AJJULIAILZ) LAND SUKVEYI6(i 694-USZ4 I HEREBY CERTIFY THAT I HAVE SURVEYED THE SCALE: FOLLOWING DESCRIBED PROPEPTY: /�=ZDV opF OA A pA�° � DATE- AND ATEAND THAT NO ENCROACHMEfNTS EXIST EXCEPT ASM Al •' INDICATED. IT IS THE RESPONSIBILITY OF THE %. TH^ OWNER TO DETERMINE THZ EXISTENCE OF ANY GRID:"' ' EASEMENTS, COVENANTS, OR RESTRICTIONS if/w/sem �r r WHICH DO NOT APPEAR ON THE RECORDED SUBDI- VISION PLAT. UNDER NO CIRCUMSTANCES SHOULD FB` fr r, •. �s/ �9 ��•i ANY DATA HEREON BE USED FOR CONSTRUCTION OF FENCE LINES, OR FOR ESTABLISHING BOUND - DRAWN: ARY LINES. per/ *^ ►�" I Municipality of Anchorage � • Department of Health and Human Services q Division of Environmental Servicesi On -Site Services Section 825 "L" Street Room 502 P.O. Box 196650 Anchorage, AK 99519-6650 www.ci. anchorage. ak. us (907)343-4744 CERTIFICATE OF HEALTH AUTHORITY APPROVAL /I �F,OzR A SINGLE FAMILY DWELLING �} c Parcel I.D. !/� � M/ - 46 HAA# /�Ft�}oW. 3 / Expiration Date: 1. GENERAL INFORMATION Complete legal description Lot 2, Block 1, Meadow Brook Subdivision Location (site address or directions) 18322 Kantishna Drive Current Property owner(s) Jim Alleva Mailing address Lending agency Mailing address Real Estate Agent_ Mailing Address PO Box 710303, Eagle River Day phone AK 99577 Day phone Day phone Unless otherwise requested, HAA will be held by DHHS for pickup. HAA picked up by: 2. NUMBER OF BEDROOMS: 3 3. TYPE OF WATER SUPPLY: Individual Well Individual Water Storage Community Class Well Public Water System 696-2500 t/a'1 /oo TYPE OF WASTEWATER DISPOSAL: ❑ Individual On-site ❑ Individual Holding Tank ❑ ❑ Community On-site ❑ Public Sewer The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Certificates of Health Authority Approval (HAA) based only upon the representations given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska. Certificates of Health Authority Approval are required for the transfer of title (except between spouses) on properties served by a single family on-site wastewater disposal and/or water supply system. DHHS also issues HAAs upon request to home owners. Certificates of Health Authority Approval are valid for 90 days from the date of issue for properties served by a private or Class C well and may be reissued with new water sample results less than 30 days old. Certificates are valid for one year for properties served by Class A or B wells or a public water system. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 72-025 [Rev. 91:001' 5. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation based on procedures outlined in the Health Authority Approval Guidelines for the Health Authority Approval application show that the on-site water supply and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on- site water supply and/or wastewater disposal system is in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. S & S ENGINEERING Name of Firm 17034 Eagle River Loop Road No. 204 Phone `t H - _, `f -7 Address Eagle River, Alaska 99577 Engineer's Printed Name Robert C. Cowan 6. DHHS SIGNATURE t/ Approved for bedrooms. Disapproved. Conditional approval for Additional Comments Date �/ :1IjCc 'ENGINEER.\ •/, m�J ROBERT C. COWAN d1�`C.'• Cc -8901 bedrooms, with the following stipulations. Attachments: HAA Checklist Maintenance Agreements Septic System Advisory Supplemental Engineer's Report Well Flow Advisory Other_ By: / i �• 7 0 �/� Original Certificate Date: Expiration Date: -5-025 (Rev. 01'001' 11z�1_(.'r Reissue Date: kECEIVED Municipality of Anchorage AUG 2224Q0 DEPARTMENT OF HEALTH & HUMAN SERV16n61k_1PAuiYOPANCHOPA_ Environmental Services Division "'"MENrA6sERvICES DIVA. 825 L Street, Room 502 • Anchorage, Alaska 99501 • (907) 343-4744 Health Authority Approval Checklist Legal Description: ZVrZ BLOCK %1/JUGd � Parcel I.D.: su3o. A. WELL DATA Well type /G If A, B, or C, attach ADEC letter. ADEC water system number/ Log present(Y/N) Total depth Sanitary seal (Y/N) Date of test Static water level Well production WATER SAMPLE Coliform Date of saa°�ole: Date completed Cased to FROM WELL LOG Nitrate Collected by: (above ground) properly protected (Y/N) AT INSPECTION Other bacteria g.p.m. B. SEPTIC/HOLDING TANK DATA Date installed /q Z Tank size (aT Number of Compartments Cleanouts5y�Ca Foundation cleanout ( ov d Depression/ (Y/N) 5J� / High water alarm (Y/N) vN) - Date of Pumping Pumper V � �S C. ABSORPTION FIELD DATA Date installed 19g 2 Soil rating (g.p.d./ft2 or ft2/bdrm) V4ZIG System type �15 i Length 6V Width / Gravel thickness below pipe, _� Total depth Effective absorption area i!/ Monitoring Tube present&) Depression over field (Yy'�� Date of adequacy test �� v v Results assS3 For / 11�� bedrooms A� r, Fluid depth in absorption field before test (in.); / i�s Immediately after gal. water added (in.): 6 - Fluid Fluid depth 3 V (ins) Minutes later:_ Absorption rate g.p.d. Peroxide treatment (past 12 months) (Y/N) NdiVF &,'WW If yes, give date 72-026 (Rev. 3/96)' D. LIFT STATION Date installed Manhole/Access (Y/N) High water alarm level at* _ T4 Cycles tested E. SEPARATION Size in gallons "Pump on" level at* SEPARATION DISTANCES FROM WELL ON Septic/holding tank on lot Absorption field on lot Public sewer ma' Sewer /s is service line V, *Datum On adjacent lots On adjacent lots "Pump off" level at* Public sewer manhole/cleanout Lift station SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK ON LOTTO: Foundation Property line Absorption field 4- Water main/service line /0 Surface water/drainage 407 1 Wells on adjacent lots} SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOTTO: Property line /Q Building foundation /0 Water main/service line % i%U l g g Surface water Driveway, y, parkin /vehicle storage Curtain drain /W� lCi,/( /�l Wells on adjacent lots /V _ F. ENGINEER'S CERTIFICATION l certify that I have determined thru field inspections and review of Municipal recQ in conformance with MOA gu'd lines in effect on this date. 1%i N!t! Signature i! rPaa�2T Engineer's Name 0 ul�tN T 1 Date NAA Fee $ (3 CV r M Waiver Fee $ Date of Payment S / 27-CrD Receipt Number 6 -2-1 1-f()4 71 72-026 (Rev. 3/96)* Date of Payment Receipt Number ROBERT C, COWAN CE -8801 r�= G are ter' 4 EXCAVATION WORK -- / J'� /\ ✓ L I 31 k ROBERT A. SHAFER CIVIL ENGINEER 694-2979 v C� vv/1-"els /41v N 2--z SRB 196X EAGLE RIVER, ALASKA U —G I MUNICIPALITY OF ANCHORAGE • '� DEPARTMENT OF HEALTH & HUMAN SERVICES�� Division of Environmental Services On -Site Services Section P.O. Box 196650 Anchorage, Alaska 99519-6650 343-4744 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING Parcel I.D. # (1�L -1q\ — 1 2. 3. 4. HAA # 6� �9 '-)11 '-)Q1 � GENERAL INFORMATION Complete legal description LOT 13&1<'1 A!24 �i P: �WB Location (site address or directions) 8322 �<ANrcSiVAM RD F,,g 661E R1 (/6914 A K 9957 7 Property owner IVR i�EA17_ �� /� Day phone 6 94 71172 Mailing address 12S A30 145) Lending agency Mailing address. Agent Address Unless otherwise requested, HAA will be held for pickup. NUMBER OF BEDROOMS: TYPE OF WATER SUPPLY: Individual well Community well Public water k Day phone Day phone NOTE: If community well system, provide written confirmation from State ADEC attest- ing to the legality and status of system. TYPE OF WASTEWATER DISPOSAL: Individual on-site Holding tank Community on-site Public sewer NOTE: If community wastewater system, provide written confirmation from State ADEC attesting to the legality and status of system. 72-025 (Rev. 1/91) Front MOA N21 5. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of this Health Authority Approval application shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is in compliance with all Municipal and State codes, ordinances, and regulations in effect on the date of this inspection. Name of Firm 0/// C AI SM6,7_11W i1V62S Phone 345- 1385 Address % ��>,4NCf->lOr�i4F A9951� 3� Engineer's signature 6. DHHS SIGNATURE xApproved for 7 �2>� bedrooms. Disapproved. Conditional approval for Additional Comments A-7 . I - By: 111TIC ROEERT W. WEIGHT s c..-8156 bedrooms, with the following stipulations: Date 9 ., )-`/ _ 9_,�3 The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority Approval Certificates based only upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHHS does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHHS do not conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 72-025(Aay.1/91) Back MOAN21 A% 1 • If1.• ROEERT W. WEIGHT s c..-8156 bedrooms, with the following stipulations: Date 9 ., )-`/ _ 9_,�3 The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority Approval Certificates based only upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHHS does this as a courtesy to purchasers of homes and their lending institutions in order to satisfy certain federal and state requirements. Employees of DHHS do not conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 72-025(Aay.1/91) Back MOAN21 Municipality of Anchorage Department of Health and Human Services 44 HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: Y!/ Parcel I.D. B,e�l< suB A. Well Data 0,4 , Cl 7Y Wi47-eR �Y�TEMJ Well type Log present (Y/N) Total depth Sanitary seal (Y/N) Date of test Static water level Well flow Pump levell If A, B, or C, attach ADEC letter. ADEC water system number Date completed Cased to Driller Casing height _Wires properly protected (Y/N) L' FROM WELL LOG �/VA) AT INSPECTION J) o�� SEPARATION DISTANCES FROM WELL TO: Septic/holding tank on lot Absorption field on lot Public sewer main to g.p.m. g.p• •2- c t1d 44,V `✓�t I = r On adjacent lots ,y 4 ; On adjacent lots Public sewer manhole/cleanout Sewer service line Petroleum tank WATER SAMPLE RESULTS: (/,//-I> Coliform Nitrate Date of sample: Collected by: B. SEPTIC/HOLDING TANK DATA Other bacteria 4 91 Date installed Z 7Z ® Tank size 1(!�2006AZ_ 0 Compartments ZIA4< 9 , /t Cleanouts (Y/N) o Foundation cleanout (Y/N) s��Depression (Y/N) /Y 0 High water alarm (Y/N) NA Alarm tested (Y/N) / NA /�° Date of pumping (944192— Pumper c �,RS P�j//yCT ��r P�iP �Ni✓�SM/�N 9/Z 93 SEPARATION DISTANCES FROM SEPTIC/HOLDING AN TO: Well(s) on lot AM On adjacent lots &4 Foundation S G % _0 To property line Igicr / Absorption field 3 0>C7_OWater main/service line W,47-69 5-, RV10E /S ��jcRONFadr Surface water/drainage #0I/sE, jd� 06<5-91e 11v Fil5co 72-026 (3r93)• Front V rRegm 0ocuMENrs OA/ Cl6i5 6, oNHS CONTINUED ON BACK PAGE pe,-,�Z ~41459 vER C. LIFT STATION CNA Date installed Size in gallons Vent (Y/N) High water alarm level _ "Pump on" level at Meets MOA electrical codes (Y/N) SEPARATION DISTANCE FROM LIFT STATION TO: Manufacturer Manhole/Access (Y/N) "Pump off" Level at Cycles tested Well on lot On adjacent lots Surface water D. ABSORPTION FIELD DATA Date installed 9 ZZ 0 Soil rating (GPD/Ft2) 1,1A1K Z System type6,e6PA6E P/% Length Zf/ UZ Width 1 Ar (23 Gravel thickness ?%J Total depth f� , /z Total absorption area ��f 0 Cleanout present (Y/N) _Depression over field (Y/N) /V Date of adequacy test V2Z 9,3 Results (pass/fail) FA 55 for 3 Bedrooms Water level in absorption field before test 0 After test Peroxide treatment (past 12 months) (Y/N) At 6 If yes, give date SEPARATION DISTANCE FROM ABSORPTION FIELD TO: Well on lot NA- On adjacent lots NA Property line 14- F% (0 To building foundation 315 F! 0 To existing or abandoned system on lot /1V/0 HE On adjacent lots 78�T 0 Cutbank 1\161\/E Water main/service line WA7-69S99V/CE � R��RT Surface water IVA Driveway, parking/vehicle storage area ,57F% 0 Curtain drain NDS! E E. ENGINEER'S CERTIFICATION I certify that t have checked, verified, or conformed to all MOA and HAA guidelines in ef( t�Jb kq of this inspection. 1,90) >> Signature �!%?1�� d'y/ `'V/� �De7" Gi/ lit/,e�flT Engineer's Name 56 Date ZZ Y .3 HAA Fee $ XDD '`-0 Waiver Fee $ _ Date of Payment 7-7- 2 ' TJ Date of Payment Receipt Number 5 9 �Zy Receipt Number- 72-026 (3/93)' Back u' MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION DIVISION OF ENVIRONMENTAL HEALTH U CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL. �j OF ON-SITE SEWER AND WATER FACILITY 1S 264-4720 Application Date 1. GENERAL INFORMATION (a) .Legal Description (include lot, block, subdivision, section, township, Location (address or directions) (b) Applicant NameTelephone: Home Business Applicant Address 2)� �r2 I P) V�� (c) Applicant is (check one): Lending Institution ❑ ; Owner/builder- Buyer ❑ ; Other ❑ (explain); Onsite Public ❑ Community ❑ Holding Tank ❑ Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. Page 1 of 2 72-025(11/84) I VO, � I I 7 1, Z to Z abr.d -NAom s,aaau!6ua leuo!ssaload ay} ul suo!ss!wo ao sjoija jol a!q!suodseA lou si a6eaoyouy to (l!!ed!o!unw ayl ,panss! si aleo!1!Uao a aaolaq elep azAleue jo suo!loadsui lonpuoo lou op d3Ha to sa@Ao!dw3 •sluawaJ!nbaa a}els pue !eaapal u!epoo Als!les of Aepio ui suo!lnl!lsui bu!pua! a!ayl pue sawoy to saaseyoand o} (salanoo a se s!yl saop d3Ha ayl 'e�se!y to ale1S ayl ul paaa}s!69A aa9u!6ua !euo!ssaloid luapuedepu! ue Aq anoge g 4dej6eied ul uaA!6 suo!leluesaidaa ayl uodn F!a!os paseq saleo!1!liao !enoiddy Al!joylny y11eaH sanss! (d3H(l) uo!}oalad 1e}u9wuoa!Au3 pue ylleaH to luawljedaa a6eaoyouy to Al!!ed!ounw ayl NOl nvo !enojddy !euo!l!puo0 to swaal n NOI1t/WIiOdNI (INV t/lyO'HOat13S 3lld'S1S31'SNOliO3dSNl JNIOIAOHd VJ I JNI!l33NIJN3 5 A. WELL DATA MUNICII MUNICIPALITY OF ANCHORAGE (MOA) AIRY OF gNCFiqEAWH AUTHORITY APPROVAL (HAA) ENVIRONMENTAL SERVICES DIVIS�CKLIST - FEBRUARY 1984 264-4720 110(1 2 61981 �, �d i V E D Legal Description: A"C4' -- Well Classification `` If A, B, C, D.E.C. Approved (9q) Well Log Present (Y/N) Date Completed Yield Total Depth Cased to _ Depth of Grouting Static Water Level Pump Set At Casing Height Above Ground Sanitary Seal on Casing (Y/N) Electrical Wiring in Conduit (Y/N) Separation Distances from Well: To Septic/Holding Tank on Lot To Nearest Edge of Absorption Field on Lot To Nearest Public Sewer Line Cleanout/Manhole Water Sample Collected by Water Sample Test Results Comments M. O, 0 Depression Around Wellhead (Y/N) On Adjoining Lots On Adjoining Lots To Nearest Public Sewer To Nearest Sewer Service Line on Lot ; Date B. SEPTI C/H4*9+N9-TANK DATA a - Date Installed 00 --MIL Size `� �� No. of Compartments Standpipes tel) Air -tight Caps ff%) Foundation Cleanout (Yt Q Depression over Tank (Y Irk Date Last Pumped E�) e�7 Pumping/Maintenance Contract on File (Y/N) ; for Holding Tank High -Water Alarm (Y/N) Temporary Holding Tank Permit (Y/N) N P Separation Distances from Septic/Hakloittcg Tank: To Water -Supply Well � � I'- To Building Foundation 45 1 t To Property Line 5 a 4- To Disposal Field 1S 1 To Water Main/Service Line o '1 To Stream, Pond, Lake, or Major Drainage I Course comments�Y � �VILpf3►-� �� �i�L,lZdi�u ( 'Toe Lr E� 2, �) /Q 112b M Page 1 of 2 72-02.6(11/84) C. ABSORPTION FIELD DATA -X���1(�D Soils Rating irLAbsorption Strata �� !� ��i1 Type of System Design Date Installed 01I� rg''7 ,9 -73 Length of Field tJ ) 1 1 Width of Field S Depth of Field fo I I Gravel Bed Thickness '3•� ' to Square Feet of Absorption CAreqt38 Standpipes Presentd9N) Depression over Field (Y Date of Last Adequacy Test �12--137Results of Last Adequacy Testb� Separation Distance from Absorption Field: To Water -Supply Well 2+� 14 To t pp y To Property Line �y To Building Foundation t To Existing or Abandoned System on Lot 1 p ; On Adjoining Lots <�),::> I„ _ I To Water Main/Service Line To Cutbank (if present) 8r� To Stream/Pond/Lake/or Major Drainage Course � C> -q t + To Driveway, Parking Area, or Vehicle Storage Area Comments t��(i1�31-r✓ o �PL Pr/�f�� 1k 'Vr_� { iz�tc d✓ -0 Tri D. LIFT STATION Date Installed Dimensions Size in Gallons Manhole/Access (Y/N) "Pump On" Level at "Pump Off' Level al High Water Alarm Level at Vent (Y/N) Tested for Electrical Codes (Y/N) Comments "' Check Permitted Bedroom Rating Against HAA Request "' Pumping Cycles during Adequacy Test. Meets MOA I certify that I have checked, verified, or conformed to all M A and HAA guidelines in effect on the date of this inspection. Signed S& &SENGINEERING date Z g 7 17034 Eagle River Loop Roado. 204 Compag4le Fiver, Alaska 99577 MOA No. Receipt No. _ �� U Date of Payment 9 Z6 od Amount: $ Page 2 of 2 72-026 (11/84) •yy'��ccd of F.�'u��� ; �A'R rr� YiktJ41'1 n• §j,�;Y)r n `LyJ, PAOFESS\')C� Et "tc j i Et "tc CAUNI1 WALITY OF ANGI10RAGiF L1t::PAEI'!"P/IERYT OF 14FAL H AND E:NVIRONNI MIAL PROTECTION M101014 OF FAVINONNIENTAL HEAL'rm CLRTIF ICATE OF INSPECTIO[J FOR HEAL'i H AUTHORITY APFFIOVAL. Of= O(d SiTI= SC-.WEH AND WATER FACIL_I I -Y 264-020 Qplicabon Date 81_ITZ(>a—_. I. GENHIAL INF'E){;lAY%j'i(jM (a) Legal Descnpuen (inciucie lot, bfccl<, s-lbd.'vision, section, township, range) _LoL 3,_Moc—l-, 1 Headow Brunk ubck, L�14N R1jJ. Soc 12 L Ocahoo (address or di, oct;ons) 100-_ldii uCi C_i-[,c.'_e (b) Applicaht Nano �,_�7:'-r._-. loleuhone: home IBUSiness NSA _ Appp lCa[I. llCdr2:- _ I_I_ � t, __. �_E' n_;�� _:--. _�•-�" C__, C- �L (c) Applicant i, vnej. I ,-nbay inwAutlon -1 Owncr,bwldoi trl ; Buyer 111 , OU)er Ll (c._plain), (C!) i._enCliilg Ksmunoft 1ZAodresa-Dell rl=i AL_1S 1"r_,_�'•Si�1.17" �';^ _____-_- - ---.--- (e) Real Fstala I; hIpanyandAodnt �_'.'1 fori2 13acoll Adarew Q�?n r 9957- ICKPADno 10 [nail the FLA A W Ma &Wng acdress: P 1 -c k ur) 2 TYPE M Single amlly (kl UJI i Family U Other (dumber of Beclrocros —- - --_--- -__-__ - J. IXII i E t Individual VNe'I i__7 Conunun;ty L Public Cil Noty I corrll vim / VJ211 system, ioust have 4Nltien conflrwa,ion from the State Department of L.nvlrorlrnental Conservation altc'Stlnq to the !t'�3iii;/ find to 32u3. Onsite C`_3 Public 0 Conuau"Q rl 1 olciing Tank 0' N4 )h: h cornnlur !y "WT eystern, ITILM have winien ccuibi nabon from the We D partmer`t of Ln ;.Ir,nrr.�•r,Lr C once vat cn athrUng to the hgawy ar_d (Ia UJs_ oWn i=Q• Page 1 0` 2 5. FiNGINf..HRING FlIFIM PROVIDING INSFJE' YlWAS, TES o, FILE SEAI1CH, DATA ANIS INFORMATION As certified by my seal affixod hereto and as of the validation date shown below, I verify that my investigation of this Health Authority Approval shows that the on-site Water supply and/or wastewater disposal systern is safe, functional and adequate for the number of bedrooms and iylre of structure indicated herein. I further verify that based on the information obtained I orn the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wa,aJowater disposal systern is in compliance with all Municipal and State codes, ordinances, and regulations in effect on the date of this inspection. Name of Firm ----...-----------------.-,-.-----.-_--. -- Telephone Address ..... IIIVEfI I"NGIN' IEIiIN 1- N'tGii;i _-____-------__--- s fIGU RIVER, Xf, 096 1 Date C ti Engineer's Seal 6. 0111i�p APPRIJV/'3 Approved for -i t -L " bedrooms b%/ Approved- _--._ Disapproves; --- - --- - - - -- _Conditional =------------- - _ __..- ---- Terms of Conditional Approval CAWf1DN The irur,cinalliy of Anchorage Department of Health and Environmental Protection (DHEP) issues Health Authority Approval certificates based upon the representations given in paragraph 5 above by an independent proicssional engineer registered in the State of Alaslc::. _fhp DI -IEP does this as a courtesy to hiurchas ,rs o horses and their lending institutions In order to satisfy certain federal and state requnernents. F-mployees of 01-1CP do nor conduct inspections or analyze data before a certificate is I cued, Ilio Municipality of ,Anchorage is nor responsible for errors or ornissions in the profess!onal ongmuur _'a work. I'a(.W 2 of 2 MUNICIPALITY OF ANCHORq(;E DEPT. OF HEALTH a ENVIRONMENTAL PROTECTION RECEIVED A. WELL DATA N)l Well Classification V Well Log Present (Y/N) Total Depth Static Water Level — MUNICIPALITY OF ANCHORAGE (MOA) HEALTH AUTHORITY APPROVAL (HAA) CHECKLIST - FEBRUARY 1984 284-4720 &14L Cased to Legal Description: / 6 -3 dlh-/ it roe)n -S4 &dv 7— / 4 ry le n w -Ci-ft- 1 i. If A, B, C, D.E.C. Approved (Y/N) M•61A Date Completed Yield Depth of Grouting Pump Set At Casing Height Above Ground —_ Sanitary Seal on Casing (Y/N) — Electrical Wiring in Conduit (Y/N) Depression Around Wellhead (Y/N) Separation Distances from Well: To Septic/Holding Tank on Lot To Nearest Edge of Absorption Field on Lot To Nearest Public Sewer Line Cleanout/Manhole Water Sample Collected by Water Sample Test Results Comments B. SEPTIC/HOLDING TANK DATA ; On Adjoining Lots — On Adjoining Lots — To Nearest Public Sewer To Nearest Sewer Service Line on Lot ; Date :°�e Date Installed 19.74 _ Size 25-0 No. of Compartments Standpipes (Y/N) ._ X Air -tight Caps (Y/N) Foundation Cleanout (Y/N) Depression over Tank (Y/N) 11.% Date Last Pumped /'9k5 / 5S5` Pumping/Maintenance Contract on File (Y/N) — All -4 ; for iv iA Holding Tank High -Water Alarm (Y/N) /�//4 Temporary Holding Tank Permit (Y/N) Separation Distances from Septic/Holding Tank: , To Water -Supply Well °C' Y To Building Foundation _ To Property Line /ed ` To Disposal Field 3 •h To Water Main/Service Line To Stream, Pond, Lake, or Major Drainage Course y`"`- - Comments Page 1 of 2 72-026111/841 C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata Liffe: Hw>Y P - Type of System Design —�ea?� , L Date Installed /e 19 � 3 Length of Field Width of Field tiovKty Depth of Field Gravel Bed Thickness rf Square Feet of Absorption Area 60o Standpipes Present (Y/N) Z Depression over Field (Y/N) %� Date of Last Adequacy Test .Akr i� /5d'-J— Results of Last Adequacy Test 5 J XCet'eiI Separation Distance from Absorption Field: To Water -Supply Well and t To Property Line rr To Building Foundation S To Existing or Abandoned System on Lot Nom. On Adjoining Lots 30"' To Water Main/Service Line fU r To Cutbank (if present) To Stream/Pond/Lake/or Major Drainage Course To Driveway, Parking Area, or Vehicle Storage Area Comments D. LIFT STATION Date Installed Size in Gallons "Pump On" Level at High Water Alarm Level at Tested for Electrical Codes (Y/N) Comments Dimensions Manhole/Access (Y/N) "Pump Off" Level at Vent (Y/N) Pumping Cycles during Adequacy Test. Meets MOA ** Check Permitted Bedroom Rating Against HAA Request ** I certify that I have checked, verified, or conformed to all MOA and HAA guidelines in effect on the date of this inspection. Signed Date ghlai Company —6FIe MOA No. 65� Receipt No.72�1u��)� �- Date of Payment C 6 1� n �C+�; �: Amount: $ ��oo°�� 0o04e�t Engineer's Seal LyC ° °pa p°°n Pae2of2 ma °= gO��oQ- Louis A. 41 °0 C� 736 °�� 72-026 (11/84)��Ij��")WESS\,J i�t/ EAGLE RIVER ENGINEERING SERVICES x J 4 1 Lou13utcra 1 .I;. u P.O.'Box 773294 Eagle River, Alaska 99577 Telephone (907) 694-5195 WELL AND SEPTIC SYSTEM ADEQUACY TEST Legal: Lot 3, Block 1, Meadow Brook LOCATION: Eagle River RESIDENCE: Single Family, 2 Bedrooms WATER SYSTEM:Public SEPTIC SYSTEM: From Municipal Records Tank: 750 gallons Absorbtion System: seepage pit INSTALLATION DATE: pre -1973 DATE OF TEST: August 1,1985 TEST PROCEDURE: The drainfield was charged at a steady flow rate of 6 GPM. A total of 635 gallons of water was added to the drainfield over a 150 minute period. Both the septic tank and the drainfield water levels were monitored. The water level in the septic tank remained the same during the duration of the test. Water level in the drainfield was measured at 271" above the bottom of the field at the begining of the test and 33 inches above the bottom after the addition of fresh water. The sump level returned to 29V after 120 minutes indicating acceptance. The tank was pumped on August 2,1985. TEST RESULTS: Both the water and septic system meets the require- ments of the Municipality of Anchorage for residential use as of the day the system was tested. There is no guarantee that the systems will continue to meet these requirements. The opera- tional life of all water and septic systems depends on the local soil conditions, groundwater levels that may fluctuate during the year, subsurface conditions that may not be observed from the surface, and water usage of the family being served by the system. . "1._-I MJTY OF ANCHORAr-` MUNICIPALITY OF ANCHORAGE (MOA) '!. OF HEALTH & v ,; ;h:ihFN'fAL PROTECTION HEAL'T'H AUTHORITY APPROVAL (HAA) CHECKLIST — FEBRUARY 1954 r r n 9 01984Lot 2 Block 1, Meadowbrook Subdivision_ ,. A. WELL DATA Well Classification I& B. or. C, D.E.C. Approved(Y/N) Well Log Present •('��'"-' c% Date Conpleted � Yield Ile//x Total Depth Cased to _ /U Depth/ of Grouting�T— Static Water Level _ '/V MP Set At Casing Height Above Ground -/,,(7 / - Sanitary Seal on Casing (Y/N)Z/ Electrical Wiring in Conduit (Y/N) / Depression Around Wellhead (Y/N)� Separation Distances from Well: To Septic/Holding Tank on Lot /07- On Adjoining Lots To Nearest Edge of Absorption Field on On Adjoining Lots To Nearest Public Seer Line %0Nearest Public Sewer Cleanout/Manhole Water Sample Collected By Water Sample Test Results Comments B. SEPTIC/HOLDING TANK DATA To/Neai;ftf Sever Service Line on Lot Date Installed �* 72 Size _ No. of Compartments Standpipes ((Y Air -tight Caps (Y � Foundation Cleanout /N) Depression over Tank g6�) Date Last >P�umped Pumping/Maintenance Contract on File (Y/N)f- for Holding Tank High -Water Alarm (Y ) Temporary Holding Tank Permit (YIN)VA Separation Distances from Septic/Hol ing Tank: To Water -Supply Vb 11, /L) To Building Foundation To Property Line �;-? V ( — To Disposal Field � / To Water Main/ServirceJLire 9K To Stream, Pond, Lake, or Major Drainage//a C RC 1/ "o )'�?�'- -� J-'"4 q -d t-1 [Page 1 of 21 2-15-84 C. ABSORPTION FIELD DATA Soils bating in Absorption Strata Ilk Type of System Design� el. 01 Date Installed 7 Length of Field Width of Field rZ Depth of Field ezl� /, CSG- c e (R : 4- Gravel fled Thickness r l�lrL Square Feet of Absorption Area O --- Standpipes Present CV Depression over Field AO Date of Last Adequacy Test Results of Last Adequacy Test Separation Distance from Absorption Field: / To Water -Supply Well/ _ Z� To Property Lire `. ell To BuildingFoundation 3 5y To Existing or Abandoned System cxi Lot. /G Z/4 , On -Adjoining Lots + To Water M nai /Service Line /-z`�— To Cutbarnk(if present) To Stream/Pond/Lake/or Major Drainage Course N To Driveway, Parking Area, or Vehicle /Storage Area�.t1_ Coments,42514 � �� 4ee1��n Zy4.1 / �sj D. LIFT STATION Date Installed Size in Gallons ".Pump On" Level at High Water Alarm Level at Tested for Electrical Codes(Y/N) Comments Dimensions Manhole/Access (Y/N ) "Pump Off" Level at m Vent (YM') es during Adequacy Test. Meets MOA ** Check Permitted Bedroom Rating Against HAA Request I certify t4t'Ih�ve check d,verified orconfortt�d tc all MOA HAA Gu on the date'of t,�( a�y�spee 7n. r Signe // L/ Date 2 Corpa MOA No. � Sia (Page 2 of 21 9�' in effect 2-15-84 February 27, 1984 A ADEQUACYTEST WATER AND SEWER INSPECTION WELL INSPECTIONS AND FLOW TEST SITE PLANS ROAD DESIGN SOILTEST ON SITE WASTE WATER DISPOSAL SYSTEM DESIGN EXCAVATION WORK ROBERTA.SHAFER CIVILENGINEER 6942979 MUNICIPALITY OF ANCHORAGE CEPT. OF HEALTH & ENVIRONMENTAL PROTECTION FCn 9 ko9� Municipality of Anchorage - C E I V E Department of Health and Environmental Protection 825 L Street Anchorage, Alaska 99501 REFERENCE: Lot 2; Block 1; Meadowbrook Subdivision; sz of the NE4; Section 12; T14N; R2W Request a Health Authority Approval be provided for the residence located on the referenced property. The following documents are provided for your information: A: Application for Health Authority Approval Certificate. B: Health Authority Approval Checklist dated February 1984. C: A sketch showing approximate location of the septic system on the referenced property. The residence located on this property is served by a community water system. The septic system was tested for adequacy and the septic tank was pumped and verified to have a capacity of 1000 gallons. The seepage pit was charged with 1000 gallons of fresh water and after a period of 24 hours all the water which had been added to the crib had percolated out. It can be concluded from this test that the waste water disposal system serving the three bedroom residence located on this property is currently functioning adequately. However, the system cannot be guaranteed against subsequent failure. if we may be of further service, please do not hesitate to contact Ila_ cc: Dynamic Realty; ATTENTION: Katie Nash SRB 196X EAGLE RIVER, ALASKA 99577 J ai !h vulS.�.J-14`7-/ ! �ar� vLv PO4 �— MUNICIPALITY OF ANCHORAGE MUNICIPALITY OF ANCHO AGE DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION DEPT. OL I ACT! I & 625 L Street - Anchorage, Alaska 99501 ENVIRONM'�NTAL ''„ CTION ENVIRONMENTAL ENGINEERING DIVISION MAR 2 f `) Telephone 264.4720 (('' FF II ���� tVcE D REQUEST FOR APPROVAL OF INDIVIDUAL WATER AND SEWEIRFF �61L DIRECTIONS: Complete all parts on paged. Incomplete requests will not be processed. Please allow ten (10) days for processing. 1. PROPERTYOWNERPHONE S,4 Al Lbi' � D. zw d.TO h NN i ,e -5 iLA R k MAI LING ADDRESS �N;?6 VAISAR OP, 'iVr:0,A/4K — PROPERTY RESIDENT (If different from above) I PHONE ,IZ/66 dGlc �ARo 4, di'A �� 2. BUYER --- PHONE MAILING ADDRESS Y� 3. LENDING INSTITUTION PHONE MAILING ADDRESS 4. REALTOR/AGENT- -� ��x/11 )&A r4�l'c _ PAriz4, j, A (14,V PHONE �71.d ¢„ MAI LING ADDRESS isfJ' Avr, A -Ale A,_A-K_ 9gej6 I 5. LEGAL DESCRIPTION Lo -1- 81 91eck 1, Ml'Ac46W ,9,0el: 514,4cl - 0 t�6ek-0d 01 P. STREET LOCATION -51" I CL I -'41z dr 61'a , 4"agle /`21 Vz 4 6. TYPE OF RESIDENCE ��� J~J NUMBER OF BEDROOMS Pq SINGLE FAMILY ❑ One El Four ❑ Other 9/ ' El MULTIPLE El Five MULTIPLE FAMILY �' — j Three ❑ Six 7. WATER SUPPLY ❑ INDIVIDUAL* * ATTACH WELL LOG. A well log is required for all wells drilled ❑ COMMUNITY since June 1975. For wells drilled prior to that date, give well P5 PUBLIC UTILITY depth (attach log if available.) 8. SEWAGE DISPOSAL SYSTEM -- -- ® INDIVIDUAL/ON-SITE **If individual/on-site, give installation date_ 75 em•ee}eard ❑ PUBLIC UTILITY , NOTE: THE INSPECTION FEE MUST ACCOMPANY EACH REQUEST BEFORE PROCESSING CAN BE INITIATED. 72-010(3/78) U) THIS SIDE FOR OFFICIAL USE ONLY INSPECTION APPOINTMENTS DATE RECEIVED TIME TIME TIME DATE DATE DATE INSPECTOR INSPECTOR INSPECTOR DIRECTIONS: 1. TYPE OF RESIDENCE ❑ SINGLE FAMILY ❑ MULTIPLE FAMILY NUMBER OF BEDROOMS ❑ ONE ❑ THREE ❑ FIVE ❑ OTHER ❑ TWO ❑ FOUR ❑ SIX 2. WATER SUPPLY ❑ INDIVIDUAL ❑ COMMUNITY ❑ PUBLIC UTILITY Connection Verified PERMIT NUMBER DEPTH OF WELL DATE DRILLED LOG RECEIVED 3. SEWAGE DISPOSAL SYSTEM ❑INDIVIDUAL/ON -SITE ❑PUBLIC UTILITY Connection Verified PERMIT NUMBER DATEINSTALLED INSTALLER ❑Septic Tank or ❑ Holding Tank Size: If Tank is homemade give dimensions: SOILS RATING TYPE OF TANK MANUFACTURER TOTAL ABSORPTION AREA MATERIAL 4. DISTANCES WELL T0: Septic/Holding Tank Absorption Area Sewer Line Nearest Lot Line Absorption Area to nearest Lot Line 5. COMMENTS APPROVED FOR rZ— BEDROOMS ❑ CONDITIONAL APPROVAL (letter mus ac mpany certificate) DISAPPROVED C DATE rj / BY (Title) 2 LEGAL DESCRIPTION /Z-UIU INev. 3/1b) AU. n1u« Vi �-, POUCI 1 6 650 ANCI IORAGE, ALASKA 99502 (907) 264 4111 C1 OP r 7.1 SULLIVAN, A 1 Y OP l.; ', W I=NT.AL ION Parch 30, 1979 Samuel D./Johnnie F. Stark 3426 Vassar Drive Anchorage, Alaska 99504 Subject: Lot 3 Block 1 Meadow Brook Subdivision Approval for your individual sewer and water facilities will not be granted until the following items have been completed: (1) The .;ept.ic tank is pumped with a receipt submitted to this office. Also, verify the number of gallons. (2) A four(4) inch cast iron cleanout be installed to the septic tank or leaching area. (3) Expose the tank for verification of its existence. (4) A percolation test be performed on the existing leaching area. This will determine if the system is adequate according to National Standards. A list of private firms who perform the test is enclosed. Notify this department for a re -inspection when descrepancies have been corrected. If there are any further questions, please contact this office at 264-4720. Sincerely, Robert C. Pratt, R.S. Associate Specialist RCP/ljw cc: Robert J. Allen Totem Realty 724 East 15th Avenue 99501 L IN U I I\ Le it E I 1ECHANICAL ENGINEER MECHANICAL ENGINEERS DAVID SLENFAV.•fP CIVIL ENGINEERS 694'9055 SR.B 196X Eagle River., Alaska 99577 April 17, 1979 MUNICIPA1lTY C�'�l'CO`�P.fl�lCocic pEfT. Subd v�lO on, Ei`;dIRCL;'."NUL _ Mr. David Star[- 3100 Iditarod Circle Eagle River, AR 99577 PML ENGINEER ROBERT A. SUFER 6942979 1, Meadowbrook 3100 Iditarod Cir A seder system adequacy test was performed on April 13 and 14, 1979 for the referenced property. The septic tank was pumped and could only be verified to have a capacity of approximately 750 gallons. The seepage 'pit was charged with 900 gallons of water and over a 24 hour period approximately 865 gallons percolated from the pit: it can be concluded that the seepaga pit is adequate for a three/f.our bedroom home, however, it appears the septic tank is only adequate to serve a two bedroom home. iI SHAFEru P.E. CF: Totem Realty AT`1'N: Bob Allen junic:i_pa]-it_y of Dept of Health Anchorage & Environmental Prot A,: sy v Rcbef, A. Nolase,r.'��t✓ 1 ��4* „D9ADf,rf oo agle River Area e GREATER ANCHORAGE AREA BOROUGH- 3- 7 ] Department of Environmental Quality 3330 "C" Street, Anchorage, Alaska 99503 274-4561 _J IU l V Date Received February 11, 1977 Time of Inspection Date of Inspection REQUEST FOR APPROVAL OF 1_�A-) o0(t INDIVIDUAL SEWER & WATER FACILITIES nn FOR Ilac2 cu ,nes t_�LSU )LP L? Cony. 1. Approval requested by: united Bank Alaska Mailing Address: 645 G Street Phone: 278-9526 2. Property Owner: Cyrus C. Mohr Phone: 694-2332 Mailing Address: 37.10 Kantishna'Drive 3. Legal Description: Lot 2 Block 1 Meadow Brook 4. Location: 3210 Kantishna Drive, Eagle River 5. Type of facility to be,inspected single Family No. of bedrooms 3 6. Well Data: A. Type Community _ B. Depth C. Construction D. Bacterial Analysis 7. Sewage Disposal System: on-site system A. Installed .1-9-7-3- )q1_, B. Installer n. �,v�c �v.,. C. Septic Tank: 1. Size 1,np,Q a4/, 2. Manufacturer D. Seepage Pit: 1. Absorption Area 2. Material _ E. Disposal Field: Total length of lines _ 8. Distances: A. Well to: Septic tank Absorption area �, Sewer Lines Nearest lot line Other contamination B. Foundation to septic tank _, Absorption area e _ C. Absorption area to nearest lot line EQ -034 (1/74) Page 1 of two pages Fdge 2 of two pages - Rec st for Approval of Individual S �r & Water Facilities Legal Description Lot 2 Block 1 Meadow Brook Comments Approved Disapproved Date�� ApprovdT Valid for one year from date signed Greater Anchorage Area Borough, Department of Environmental Quality DIAGRAM OF SYSTEM I certify that the information contained in this request for approval to be a true and accurate representation of the subject sewer and water facilities and these facilities are operating satisfactorily. SIGNED EQ -034 (1/74) Date MUNICIPALITY OF ANCHORAGE '")NICPAU'ry ul ENVIRC) AN' clIc�RAGh • DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION DEPT, U. )i: LG i 2510 East Tudor Road, Anchorage, Alaska 99504 276-2221 NMEt`.)T;\I pil��ri_G71QN -- REQUEST FOR APPROVAL OF �'�� � � INDIVIDUAL SEWER and WATER FACILITIESFEC A�,_VV, ; d 1. Type of Inspection: CMRO VA FNA CONV 2. 3. Property Owner: C ,Y �_j S C• Mailing Address:_ 3 -2— Name of Buyer: La / LL 7 4--" 0/-/ " / / 5if 7p D�Day 5,,w Phone: 5/ 3 ' �- Mailing Address: c- fl /30X c - Day Phone: 3 yV a' 4. Name of Lending Institution: 4 5'A-- Mailing Address:—a 2 z �— '" C Phone: 27 S� 5 S -Z 5. Name of Realtor or Agent: _ 2 t C IP- Mailing Address: /L. G L,_ ✓� ! v.Z 9 Phone: L� Ll 6. Legal Description: / C� �- �� K ✓��,q ao,-, ✓.��c�oK ScJ ) Location: fi/« � JCU �rF�y % 1 S /1AJ4 7. Type of Facility to be Inspected: G11V6-L /- 1A"e /2/0`N--- No. Bdrms. 0 Water Supply Type of Supply SyS�-� Public Utility Individual If Individual, number of dwellings presently served �. If Individual, depth of well Sewage Disposal System Type of System: Public Utility If Individual, date of installation 72-003(3/76) Individual (on-site) x )AA GREATER ANCHORAGE AREA BOROUGH Department of Environmental Quality 3500 Tudor Road, Anchorage, Alaska 99507 279-8686 Date Received 6 27/73 Time of Inspection Kxxxx7BX Date of Inspection 6/27/73 REQUEST FOR APPROVAL OF INDIVIDUAL SEWER & 'WATF,R FACILITIES FOR FHA 1. Approval Requested By: Eric Johnson /ASSOCIATE: BUILDERS Address: p, Q. Box 1101 p _ Phone: 2. Prooertv Owner: Phone: 3, Legal Description: Lot 2, Block -1. Meadow Brook Subdivision 4. Location: 5. Type of Facility to be Inspected:-��Simle family dwelling Number of Bedrooms: 3 6. Well Data: COMMUNITY A. Tyne C. Construction 7. Sewage Disoosal Svstem: B. Depth D. Bacterial Analysis A. Installed 1972 8. InstallerGlacier Excavating C. Septic Tank: 1., Size_ 1000 2. Manufacturer Stack Steel D. Seepage Pit: I. Size 17' X 17' 2. Material log E. Disposal Field: Total Length of Lines 8. Distances: A. Well To: Septic Tank Absorption Area , Sewer Lines Near.est Lot Lire___ Other Contamination B. Foundation to Septic Tank Absorption Area---. C. Absorption Area to Nearest Lot Line 15' _ Remiest for Approval of Ir iidual Sewer & Water FacilitieF Mage Two 9. Comments: Approve Disapproved Date / Approval Valid for One Year From Date Signed ater Anchorage Area Borough, Department of Environmental Quality DIAGRAM OF SYSTEM I certify that the information contained in this request for approval to be a true and accurate representation of the suhiect sewer and water facilities located at: Signed Date